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Acute respiratory distress syndrome. Asthmatic status. Mendelssohn Syndrome



1. Patient S., 65 years old, suffers from bronchial asthma (hormone-dependent) for 15 years. The last attack of suffocation continues the second day. I called an ambulance twice. She was admitted to the intensive care unit in an asthmatic state (stage II). Name the diagnostic criteria of stage II status, determine the sequence of IT.

2. Patient K., 40 years old, was admitted to the clinic of surgical diseases with a diagnosis of acute intestinal obstruction. After examination, the diagnosis was confirmed. According to emergency indications, the patient was taken to the operating room. During water anesthesia, the patient underwent regurgitation followed by aspiration into the respiratory tract of the gastric contents. Identify preventive measures for complications, diagnostic methods and therapy.

3. Patient S., 70 years old., Has long suffered from bronchial asthma (more than 20 years). Upon admission to the intensive care unit unconscious, acrocyanosis, expiratory dyspnea up to 40 per min, blood pressure 60/20 mm Hg, pulse 120 min. In the lungs, a significant weakening of breathing, areas of the "silent lung". Determine the stage of asthmatic status, the sequence of IT.

4. Patient I., 57 years old, was in the trauma department for a fracture of the pelvis and hip. The patient had a history of myocardial infarction twice. Before admission to the hospital, shortness of breath is disturbing. Laboratory established hemoglobin reduction to 60 g / l. HELL at admission to the intensive care unit 80/40 mm Hg In order to correct hypotension, 400 ml of polyglucin was transfused intravenously. Against the background of transfusion, shortness of breath up to 40 per min appeared, blood pressure remains at 80/40 mm Hg. Auscultatory weakened vesicular breathing with a mass of wet rales. Likely reasons for this ONE, screening plan and IT.

5. Patient M., 50 years old, was transferred to the intensive care unit with a pronounced clinic of respiratory failure. History: 10 days ago, was operated on for acute intestinal obstruction. In the postoperative period, postoperative peritonitis developed due to the failure of the sutures of the anastomosis. On admission to intensive care: stupor, acrocyanosis, tachypus up to 45 per minute, tachycardia up to 130 per minute, blood pressure 70/40 mm Hg In the lungs, auscultation - hard breathing, single wheezing, hemoglobin saturation 80%. X-ray - "blizzard". Determine the probable cause of ARF, the pathophysiological explanation of the clinical and radiological picture, prescribe an additional examination, and conduct an IT.

6. Patient K., 60 years old, was in the department of thoracic surgery with a diagnosis of bronchiectasis.
Based on the clinical and radiological examination, the patient decided to undergo surgery. On the background of mechanical ventilation there was a sharp increase in resistance to inspiration against the background of manipulations at the root of the lung without local anesthesia. Against this background, the patient had a sharp increase in the clinic of hypoxemia. It is necessary: ​​to clarify the cause of ONE, to determine the nature of IT.

7. Patient M., 70 years old, was in the department of general surgery after laparotomy, resection of the small intestine due to acute small bowel obstruction. In the postoperative period, more than 3 liters of isotonic solutions were transfused to the patient within 6 hours. In connection with the development of the clinic, ODN was transferred to the intensive care unit. It is necessary: ​​to name the most probable causes of ARF, determine the pathophysiological mechanisms, assign an examination plan and establish the sequence of IT.

8. Patient B., 40 years old, was in the department of traumatology with a fracture of the femur and tibia on the right. After 2 days, the patient developed an ODN clinic: shortness of breath up to 40 per min, hard breathing, radiological - pulmonary pattern was strengthened. Laboratory: the presence of free fatty acids in urine and blood. According to KShchS indicators: increase in pCO2 up to 57 mm Hg. Give a pathophysiological explanation, the cause of ONE, determine IT parameters.

9. Patient K., 68 years old, was in the therapeutic department for hypertension, stage II B. Against the background of the treatment, the patient experienced a sharp increase in blood pressure to 240/120 mm Hg At the same time, the ODN clinic was growing: tachypnea up to 40 per minute, acrocyanosis, heart rate up to 120 per minute. In the lungs, wet rales of different sizes are heard, according to the ECG - overload of the left heart. Worried cough with frothy sputum with an admixture of blood. Establish the cause of the deterioration, assign a survey plan and IT.

10. Patient T., 54 years old. Received in a surgical clinic with acute intestinal obstruction. The patient has a history of long-term bronchial asthma. After the examination and sedation according to emergency indications, an operation was performed in the amount of laparotomy, the elimination of obstruction. Against the background of the introduction of fentanyl, the patient worsened: blood pressure increased to 240/110 mm Hg, tachycardia to 120 per minute, reduction of saturation to 83%. According to KShchS: pCO2 increased to 60 mm Hg. Auscultation - a sharp weakening of breathing in all pulmonary fields. Give a clinical assessment of preoperative preparation, determine the cause of the deterioration, determine the nature of IT.

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Acute respiratory distress syndrome. Asthmatic status. Mendelssohn Syndrome

  1. Acute lung injury syndrome and acute respiratory distress syndrome
    Acute lung injury (ARF) and acute respiratory distress syndrome (ARDS) are nonspecific lesions of the lung parenchyma of a polyetiological nature and are characterized by: • acute onset; • ???? progressive arterial hypoxemia; • ???? bilateral infiltration of pulmonary fields on the chest radiograph; • ???? progressive decline
  2. Acute respiratory distress syndrome. Adult Respiratory Disorder Syndrome
    ICD-10 code J80 Diagnostics Diagnosis Mandatory Level of consciousness, respiratory rate and effectiveness, pulse, blood pressure, body temperature, medical history, physical examination R-graph of chest organs Blood gases Additional (according to indications) CVP DZLA During treatment Monitoring according to Clause 1.5. Additionally, hemoglobin saturation, hourly diuresis, blood gases,
  3. Acute Respiratory Distress Syndrome
    Causes of acute respiratory distress syndrome • ???? Shock. •????Sepsis. • ???? Multiple organ failure. • ???? Acute pancreatitis. • ???? The toxic effect of high respirable concentrations of oxygen. • ???? Smoke poisoning. • ???? DIC syndrome. • ???? The use of certain drugs. • ???? Aspiration, incl. water when drowning. • ???? Fat embolism. • ???? Bruised lungs.
  4. Acute Respiratory Distress Syndrome
    In recent years, more and more attention has been paid to the peculiar form of ONE, which is called "Acute respiratory distress syndrome" (ARDS). By acute respiratory distress syndrome (ARDS), we mean a severe, life-threatening form of acute parenchymal respiratory failure, developing as a non-specific phase reaction of previously intact
  5. Intensive care for asthmatic status, pulmonary edema, acute respiratory distress syndrome
    1. Obstructive ventilation disorders are caused by: 1) Swelling of the mucous membranes 2) Laryngospasm 3) Bronchospasm 4) Hematorax 5) Inhibition of the respiratory center Answers: a) correctly 1,2,3; b) correct 1,2,5; c) correctly 2,3,4. 2. Pulmonary ventilation disorders are observed with: 1) Pneumothorax 2) Laryngospasm 3) Effects of muscle relaxants 4) Poisoning with barbiturates 5) Increased pressure in the abdominal
  6. Respiratory distress syndrome
    Michaels. Lagutchik, DVM 1. Define respiratory distress syndrome, dyspnea, tachypnea, orthopnea, hyperventilation, hypoventilation, and apnea. Respiratory disorder (respiratory distress syndrome) - clearly obstructed ventilation of the lungs or ventilation that requires breathing efforts; clinically pronounced inability to ventilate and / or adequate oxygenation. Such a definition
  7. Adult Respiratory Distress Syndrome
    Adult respiratory distress syndrome (RDSV; synonyms: non-cardiogenic pulmonary edema, “shock lungs”) is an acute diffuse parenchymal lung infiltration resulting from damage and increased permeability of pulmonary microvessels. RDSV is characterized by severe hypoxemia resistant to oxygen therapy, a significant decrease in the extensibility of lungs and pulmonary volumes, and late
  8. Adult Respiratory Distress Syndrome
    RDSV (Adult respiratory distress-syndrome) is a severe form of respiratory failure characterized by specific changes in the lungs - diffuse infiltration, accompanied by non-cardiogenic edema, alveolar collapse, ONE. Despite the difference in etiological factors, they directly or indirectly affect the lungs, causing damage to the lung structures. The main symptom of the syndrome
  9. RESPIRATORY DISTRESS ADULT SYNDROME
    RDSV (Adult respiratory distress-syndrome) is a severe form of respiratory failure characterized by specific changes in the lungs - diffuse infiltration, accompanied by non-cardiogenic edema, alveolar collapse, ONE. Despite the difference in etiological factors, they directly or indirectly affect the lungs, causing damage to the lung structures. The main symptom of the syndrome
  10. Respiratory distress syndrome
    RDS is a disease of predominantly premature infants due to immaturity of the lungs and surfactant deficiency. RDS is manifested by the development of DN immediately after childbirth or after several hours with an increase in severity until the survivors recover gradually (usually between the 2nd and 4th day of life). RDS develops in approximately 20% of premature infants, and among those born before
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